Embalming Questions 2/2 Flashcards


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1

Describe the three meanings of discoloration as it pertains to embalmers.

  1. color is removed or lost
  2. to change color
  3. any abnormal color appearing in or on the dead human body

2

What are the three general types of jaundice?

toxic, hemolytic, obstructive

3

When embalming the jaundiced body, what factor takes precedence over all others?

preservation

4

This is defined as an elevation of the epidermis containing a watery liquid.

blister

5

List and describe the three categories of burns.

1st: skin surface is red, only surface epithelium involved

2nd: skin blisters and edema, destruction of deep layers of epidermis and upper layers of dermis

3rd: tissues charred, epidermis, dermis and epidermal derivatives destroyed

6

Define/describe cyanosis.

a blush color of the skin and the mucous membranes due to insufficient oxygen in the blood

7

Define exsanguination

excessive blood loss to the point of death

8

List several different embalming treatments for a jaundiced body.

Use of jaundice fluid, pre injection fluid, mild arterial solution, cavity fluid as arterial fluid

9

Give a detailed description of how jaundice occurs.

the conversion of bilirubin to biliverdin in the presence of a strong acidic environment (high HCHO)

10

What is meant by the term "reaction controlled fluids"?

able to be distributed throughout body and diffuse into tissue spaces before chemical reaction with proteins of the body

11

Describe Tardieu spots

minute petechial hemorrhages caused by rupture of minute vessels as blood settles into dependent areas of organs and tissues

12

List some examples of extravascular blood discolorations.

ecchymosis, purpura, petechia, hematoma, postmortem stain, tardieu spots

13

Why should the head and shoulders of the dead human body always be elevated?

to help drain the blood from upper tissues; blood from heart could settle in the head if not elevated

14

How can liver mortis be an advantage to the embalmer?

the breaking and clearing of liver mortis indicates that fluid has been distributed into those tissues

15

In a case of renal failure/jaundice, how is ammonia formed and what is its significance to the embalmer?

urea in the blood system converted to ammonia; ammonia neutralizes formaldehyde

16

Define a skin lesion

any traumatic or pathological change in the structure of the skin

17

What is one of the major problems encountered by the embalmer in preparing a body with diabetes mellitus?

poor peripheral circulation

18

What are the 4 categories of skin lesions?

  1. unbroken skin but discolored
  2. skin scaling
  3. skin that is broken or separated from the body
  4. pustular or ulcerative lesions

19

What is meant by the term "exanthematous" or "exanthema"?

a skin eruption accompanying certain infectious diseases; or a disease such as measles or scarlet fever, accompanied by a skin eruption

20

What is another term for skin slip?

desquamation

21

Describe the classic discoloration associated with carbon monoxide poisoning and its cause.

a "cherry red" color brought about by carboxyhemoglobin, a component of the blood

22

On a casketed body, what is a good way to detract from eye problems with may have occurred?

use of glasses

23

Describe the theory behind the conversion of yellow jaundice to green jaundice. Include the chemical process and compounds involved.

Oxidation reaction; the conversion of bilirubin to biliverdin in presence of strong acidic environment.

24

Describe how Formaldehyde gray occurs.

Failure to remove as much blood out of the body as possible, remaining blood mixes with preservative fluids and makes a dark gray color

25

List some examples of surface discolorations and when they should be cleared.

Blood, butadiene, adhesive tape marks, paint, tobacco bars - clean prior to injection because pores of skin are easier to clean at that time.

26

List four examples of pathological discolorations.

gangrene, jaundice, tumors, meningitis

27

What are the classic colors of dehydration?

yellow, brown, and black

28

What are the "warm" areas of the hands and face?

lips, cheeks, base of chin, nose, ears

29

What are some causes of dehydration?

injection of too much arterial solution, use of arterial solution that is too strong, continuous or concurrent daring, passage of air over the body

30

Why is cavity embalming important in cases of renal failure?

bleeding will often occur in gastrointestinal tract - excellent medium for bacterial growth and potential for purge

31

Regarding generalized edema, what are the two main objectives of the embalmer?

1) inject solution of sufficient strength and volume to counteract the secondary dilution that occurs in tissues

2) removes as much edema from tissues as possible

32

What is one of the leading causes of a postmortem loss of moisture?

refrigeration

33

Generally speaking, will thoroughly embalmed tissues dehydrate more or less than under-embalmed tissues?

less

34

Discuss the effect of water temperature on embalming fluid reaction.

As temperature rises: surface tension value of solution decreases, solution penetrates tissues more rapidly, chemical reactions quicker, firming occurs faster

35

What is another term for extreme dehydration?

desiccation

36

Define Edema

abnormal accumulation of fluid in tissue spaces, body cavities, or both.

37

Describe Pitting Edema

condition in which interstitial spaces contain such excessive amounts of fluid that the skin remains depressed after palpation

38

What are three body sites where edema can be found?

Cellular edema, Intercellular edema, Edema of body cavities

39

What is another term for generalized edema?

Anasarca

40

List 5 types of "body cavity" edema and describe where they occur.

Ascites: abdominal (peritoneal) cavity

Hydrothorax: plural cavity

Hydrocephalus: cranial cavity

Hydropericardium: pericardial sac surrounding the heart

Hydrocele: tunica vaginalis testis of the scrotum

41

This type of edema does NOT respond to embalming treatments and is frequently seen in facial tissues when corticosteroids have been administered.

Cellular edema (solid edema)

42

In a normal 160 lbs. adult male, what percentage of body weight does total body water constitute?

55-60%

43

Under what conditions is edema said to be established?

When there is a 10% increase in total body water

44

What is one simple way to maintain the proper moisture level during the embalming process?

follow dilution recommendation on label of arterial fluid

45

List some recommended treatments that will maintain moisture or add moisture to dehydrated bodies.

use of moderate arterial solution in large volume, slow injection, use of connection, use of humectant, use of large amounts of fluid, intermittent or alternate drainage, application of massage cream

46

Why should one avoid excessive massaging of the hands, neck and face on a dehydrated body?

it removes tissue moisture and arterial solution from the area

47

After embalming, how could done use gravity as a method of treating edema of the head, face, and neck?

place body on cot for several hours with head end fully elevated and food end fully lowered

48

What is the theory behind using a very large volume of a mild or average (standard) arterial solution to treat generalized edema?

washes out good portion of edema

49

List the 6 types of arterial solutions recommended in treating edema.

very large volume of mild/average arterial solution

very strong/astringent solution

special purpose/high index fluid designed for edema

addition of dehydrating co-injection chemicals

use of epsom salts in arterial solution

50

How is ascites affected by the arterial solution and blood drainage?

it is unaffected by arterial fluid and blood daring because it is located within the cavity around the visceral organs

51

Briefly describe how Epsom salts work on edema.

creates a hypertonic solution which sets up an osmotic gradient that draws the edema from the tissue spaces toward this concentrated salt solution in the capillaries

52

Describe the suggested arterial solution/technique using Epsom salts.

fill container with 1/2 gallon of cool water, add as much epsom salt as can be dissolved, add 4-6 oz of high index arterial fluid, massage downward

53

In what situation does the epsom salt solution work best? In what situation does it NOT work well?

works with intercellular (pitting) edema, NOT with cellular (solid) edema

54

How could a trocar be used to treat facial edema?

pass small needle through cribriform plate

55

Describe the appearance of desiccated lips and fingertips.

lips: appear black, very wrinkled and shrunken

fingers: skin becomes like parchment and turns yellow-brown

56

List some embalming techniques used to keep a good balance of moisture in the body?

  • avoid astringent or hypotonic arterial solutions
  • avoid continuous drainage
  • avoid rapid injection and drainage
  • delay aspiration
  • cover refrigerated bodies with plastic sheeting
  • avoid outdated fluids
  • use disinfectants that do not dehydrate the skin

57

What are the 3 layers of an artery?

Intima: inner layer

Media: middle layer

Adventitia: outer layer

58

Define canalization.

formation of new channels in a tissue

59

This term describes blood clots attached the inner wall of a blood vessel.

thrombi

60

What is a mycotic infection?

infection caused by a fungus

61

What is an atheroma and how might it affect the placement of the cannula?

a patchy or nodular thickening of the intimate of an artery - incision should be made where the artery is soft, a smaller cannula should be used to avoid damage to the lumen

62

Describe a febrile disease and how it can affect the vascular system.

disease accompanied by elevation of body temperature - may speed decomposition, lead to dehydration, coagula, drainage difficulties and swelling of small vessels and tissues on injection

63

This is the term for narrowing of a blood vessel.

Vasoconstriction

64

What should be done if not drainage occurs in a case of an aortic aneurysm?

stop injection and being multi-point injection

65

What other problematic condition can occur when an aortic aneurysm has been surgically repaired?

severe facial edema

66

This term refers to pressure on the outside of an artery or vein.

extravascular resistance

67

How might an embalmer treat resistance brought about by visceral weight?

above and below heart injection and daring points can be employed

68

This term describes hardening of the arteries

arteriosclerosis

69

The term used to describe inflammation of a vein.

phlebitis

70

This is a disease caused by the spirochete Treponema pallidum.

syphilis

71

List and describe the three types of arteriosclerosis.

1) inner wall hardened and thickened but lumen well defined

2) lumen reduced in size and pushed to one side of the artery

3) artery completely occluded

72

The term used to describe a detached blood clot.

embolus

73

What is ischemia?

restriction in blood supply generally resulting in damage or dysfunction of tissue

74

The term describing an increase in red blood cells.

Polycythemia

75

The condition in which the heart cannot pump enough blood to the organs of the body.

congestive heart failure

76

When embalming a case of an aortic aneurysm, what would little or no drainage indicated?

loss of embalming solution into thoracic or abdominal cavity

77

Which artery is most likely to be affected by arteriosclerosis?

femoral

78

A condition caused by poor arterial circulation into an area of the body, causing death of body cells.

dry gangrene

79

A condition caused by occlusion of veins draining a body area that becomes the site of bacterial infection.

wet gangrene

80

A term describing the localized dilation of an artery.

aneurysm

81

What is a main embalming concern of diabetes?

poor circulation due to arteriosclerosis

82

Of the two types of gangrene, which type cannot be treated arterially?

dry

83

List some potential complications of congestive heart failure.

blood congested in right side of heart, neck veins become engorged with blood, lips ears and fingers often cyanotic, generalized pitting edema, edema of legs/feet and ascites may be present

84

With regard to fluid injection, how might an embalmer avoid dislodging coagulation in the vascular system?

inject with a slow rate of flow

85

The term which describes an endocrine disease affecting the control of blood glucose levels.

diabetes

86

In cases of advanced decomposition, what are one of the last "organs" to decompose?

arteries

87

This is the organism responsible for the formation of tissue gas and gas gangrene.

clostridium perfringens

88

Describe subcutaneous emphysema.

dissension of the tissues beneath the skin by gas or air; an antemortem condition brought about by a surgical procedure or trauma; e.g.: CPR that breaks a rib which punctures a lung, allowing air to escape into the body cavity.

89

What are the five gases that are found in the dead human body and case distension?

  1. subcutaneous emphysema
  2. air from embalming apparatus
  3. gas gangrene
  4. tissue gas
  5. decomposition gas

90

the term used to describe a blister filled with serous fluid which is usually caused by tissue gas.

bleb

91

What are the two categories of facial trauma?

-injuries in which the skin is broken

-injuries in which the skin is not broken

92

List some signs of renal failure.

sallow color to the skin, excoriations on the skin from repetitive scratching due to uremic pruritus, distinct odor from increased amount of urea, ammonia, edema, etc.

93

The term used to define the postmortem evacuation of any substance from any external orifice of the body.

purge

94

There term used to describe a severe systemic itching sensation affecting kidney dialysis patients.

pruritis

95

What are four ways that pressure responsible for purge can develop?

gas, visceral expansion, arterial solution, ascites/hydrothorax

96

What two factors are needed for purge to occur?

-a substance to purge

-pressure on an organ to evacuate the material

97

How should the embalmer proceed when arterial solution is present in purge and drainage has stopped?

a sectional injection will need to be implemented because a major fluid loss is taking place & distribution is not happening

98

List three types of mycotic infections.

Aspergillosis, Phycomycosis, Histoplasmosis

99

List two precautions all embalmers should take when a mycotic infection is suspected.

-do not compress the abdominal or thoracic cavity

-handle bodies with gloves

-use a sporicidal arterial fluid

100

When positioning an obese case, why is keeping the head high important?

easier to raise vessels and helps prevent purge

101

This type of gas usually stops when tissues are properly embalmed.

decomposition gases

102

With regard to renal failure, how much more preservative chemical than normal is needed to achieve preservation?

6x more preservative chemical

103

What ingredient of stomach purge can dry and discolor the skin?

hydrochloric acid

104

Define saprophytic fungi.

obtains nourishment from dead organic material

105

Why is disinfection of instruments so important after treating cases of tissue gas and gas gangrene?

clostridium perfringens can be passed form one body to another via contaminated instruments

106

This is a fatal disease caused by contamination of a wound infection by a toxin-forming, spore-forming anaerobic bacterium.

gas gangrene

107

How should the embalmer proceed if arterial solution is present in purge and drainage is occurring?

continue injecting until the preservative demand is met

108

In the dead human body, what two factors are responsible for decomposition?

bacteria and autolytic enzymes

109

How would an embalmer create a "barrier" between an extremity exhibiting tissue gas and the rest of the body?

by hypodermically injecting undiluted cavity fluid after sectional embalming is completed

110

Why might an embalmer raise the iliac artery to inject the leg of an obese case?

it is more superficial than the femoral artery; arteries in obese cases can be quite small

111

The term used to describe an agent having an affinity for metallic ions such as calcium and magnesium.

chelating agent

112

The term defined as the amount of radioactive material in which 37 million atoms disintegrate each second.

milicurie

113

What are the two main classes of chemotherapeutic agents?

cytotoxic, antimetabolite

114

These are specialized proteins that break down other proteins.

enzymes

115

What is the term for the treatment of disease with chemical agents and drugs?

chemotherapy

116

Which organ would a nephrotoxic chemotherapeutic agent adversely affect?

kidney; cause a breakdown in kidney function

117

Describe how a chelating chemotherapeutic agent affects the cell membrane.

they have an affinity for metallic ions (particularly calcium and magnesium) and tend to lodge in the cell membrane, creating an impenetrable layer of calcium around the cell

118

With regard to embalming complications, what is the main effect of corticosteroids?

they block the cell membrane by decreasing its permeability

119

This is the term describing the physical wasting with loss of weight and muscle mass caused by disease.

cachexia

120

Describe the difference between the two general classes of chemotherapeutic agents.

Cytotoxic drugs: act directly on (tumor) cells to bring about their death

Antimetabolite drugs: substitute for an essential metabolite required by (cancer) cells for growth (depriving tumor cells of nutrition)

121

What are the five general classes of tranquilizers and mood-altering drugs?

  1. sedatives
  2. stimulants
  3. tranquilizers
  4. narcotics
  5. anti-depressants

122

What are the two types of chemotherapeutic agents used to control diabetes? (Include their "market" names as well.)

Tolbutamide (orniase)

Chlorpropomide (diabinase)

123

List some problems caused by the use of corticosteroids.

cell membrane less permeable, fluid retention, mild to severe water logging of tissues, "protects" proteolysis enzymes, gastrointestinal ulcerations and perforations of the gut, disseminated tuberculosis

124

List some problems caused by antibiotics.

cotton-like circulatory blockages (fungal growth), jaundice, bleeding into the skin, poor penetration

125

How might an embalmer restore permeability to cell membranes affected by corticosteroids?

use of a pre injection will restore some permeability; the surface-acting chemicals (surfactants) will facilitate entry of the preservative into the cells

126

This is the body's main center of detoxification.

liver - the hepatic circulation system

127

What are two ways embalming renders proteins resistance to catalytic enzymes?

-treating the proteins so they aren't susceptible to enzymes

-rendering the enzymes inactive so they cannot act on other proteins

128

When re-embaling the unautopsied body, why might a multi-point injection by required?

because cavity embalming already completed disrupts the vascular system

129

When storing a casketed body for delayed viewing, should the casket be sealed or unsealed and why?

casket should be left unsealed because sealing the casket encourages mold growth

130

List some reasons for a delayed viewing.

family needs to make travel arrangements, difficulty in locating the family, remains are being shipped to a different country, family members are waiting for someone to be released from the hospital

131

What are two major concerns in long-term storage at a medical school?

dessication and mold

132

Define a common carrier.

any carrier required by law to convey passengers or freight without refusal if the approved fare or charge is paid; travels according to a set schedule

133

What are the three categories of shipping?

  1. intrastate
  2. interstate
  3. international

134

Define a private carrier.

an individual or company that transports only in particular instances and only for those whom it chooses to contract

135

What are some occasions in which re-embalming would be necessary?

  • fluid not distributed to all areas
  • too little solution was injected
  • concentration of fluid was too low and preservative demand not met
  • injected solution was neutralized by body chemistry
  • rigor mortis was mistaken for tissue fixation

136

What are three major factors that affect the degree and length of preservation?

  1. condition of body at time of preparation
  2. embalming thoroughness and chemical formulations
  3. aftercare

137

What are some objectives accomplished by long-term preservation?

families have assurance of professionally prepared loved one and subsequent peace of mind; greater value, function and purpose of protective products surrounding the deceased

138

Describe the differences between an air try and a combination air tray.

Air tray: for casketed remains only the bottom is wood; side, ends and top are made of heavy-grade cardboard

Combination Air tray: wood-based container with sides, ends and inside top all made of wood with an exterior cardboard covering

139

List some responsibilities of a shipping funeral home.

  • removal from place of death
  • embalm and thoroughly preserve remains
  • prepare an embalming case report
  • secure necessary documents
  • arrange for private or common carrier transportation
  • communicate to receiving fh condition of remains and scheduled timed

140

Why should a casket not be completely sealed before shipment on a commercial airliner?

to allow for air pressure changes inside cargo hold of the airplane

141

How would a funeral director obtain the regulations required to ship a body to a foreign country?

notify local consulate of foreign country and obtain regulations

142

According to the text, how long might a funeral director expect the processing of international shipping to take?

5 to 14 business days

143

This is the term used to describe a container that is airtight and impervious to external influence; or one that is completely sealed by fusion or soldering.

hermetically sealed

144

What are some (generally) required documents needed for international shipping?

  • certified copy of death certificate
  • non-contagious disease letter
  • embalmer's affidavit
  • non-contraband letter
  • Apostille

145

List some responsibilities of a receiving funeral home.

  • avoid making promises to family about time/date of services
  • cooperate with shipping funeral home in providing statistical info
  • be prepared for unexpected delays

146

What are some embalming restrictions when shipping to Israel?

Israel does not require embalming, but if embalmed, the remains must be embalmed by the gravity method and no drainage taken